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Anaphylaxis in the United States
An Investigation Into Its Epidemiology
Alfred I. Neugut, MD, PhD;
Anita T. Ghatak, MPH;
Rachel L. Miller, MD
Arch Intern Med. 2001;161:15-21.
Background Anaphylaxis is a severe, life-threatening allergic reaction that affects
both children and adults in the United States. However, data regarding the
incidence and prevalence of anaphylaxis and the number of deaths caused by
it are limited.
Objective To provide a better understanding of the magnitude of the problem of
anaphylaxis in the United States.
Methods A thorough review of the current medical literature was conducted to
obtain prevalence estimates on each of the 4 major subtypes of anaphylaxis
(food, drugs, latex, and insect stings). We calculated an overall estimate
of the risk of anaphylaxis by using only estimates that are specifically derived
from epidemiologic studies measuring anaphylaxis in the general population.
Results Known rates or cases of anaphylaxis were 0.0004% for food, 0.7% to 10%
for penicillin, 0.22% to 1% for radiocontrast media, and 0.5% to 5% after
insect stings. There were 220 cases after latex exposure. Considering the
1999 US population of 272 million, the population at risk for anaphylaxis
from food is 1099, from penicillin is 1.9 million to 27.2 million, from radiocontrast
media is 22 000 to 100 000, from latex is 220, and from insect stings
is 1.36 million to 13.6 million. These calculations yield a total of 3.29
million to 40.9 million individuals at risk of anaphylaxis.
Conclusion The occurrence of anaphylaxis in the US is not as rare as is generally
believed. On the basis of our figures, the problem of anaphylaxis may, in
fact, affect 1.21% to 15.04% of the US population.
From the Department of Medicine (Drs Neugut and Miller) and the Joseph
L. Mailman School of Public Health (Dr Neugut and Ms Ghatak), College of Physicians
and Surgeons, Columbia University, New York, NY. Drs Neugut and Miller and
Ms Ghatak have acted as consultants to the DEY Corporation, Napa, Calif.
Corresponding author: Alfred I. Neugut, MD, PhD, Department of Medicine,
College of Physicians and Surgeons, Columbia University, 630 W 168th St, Room
PH18-127, New York, NY 10032 (e-mail: ain1{at}columbia.edu).
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